Abortion Questions and Answers by Jack Wilke, MD:Chapter 14,

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Immediate Physical Complications and Under-Reporting

The major immediate complications of abortion are infection, bleeding, and perforation of the uterus.

What of the validity of studies?

In all reports on physical safety or harm from abortions, it is important to remember one fact. Literally all studies have been done in the medically sophisticated setting of university hospital centers, and by highly trained surgeons. These, however, constitute less than 10% of abortions done.

Over 90% of abortions in the U.S. are done in unsupervised free-standing clinics. These are done without pre- or post-surgical care, on an assembly line basis, for cash, and often by doctors with minimal training, unsophisticated equipment, and inadequately trained personnel.

Clearly, the safety of abortions done in such clinics cannot be compared to that in a university hospital. Clinics probably have double or triple the number and seriousness of the physical complications reported in the following studies:

How often do women get infection as a consequence of induced abortion?

A study from one of the most prestigious medical centers in the world, John Hopkins University, reported: "Occurrence of genital tract infection following elective abortion is a well-known complication." This institution reports rates up to 5.2% for first trimester abortions and up to 18.5% in midtrimester.
Burkman et al., "Culture and Treatment Results in Endometritis Following Elective Abortion," Amer. Jour. OB/GYN, vol. 128, no. 5, 1977, pp. 556-559.

For the local freestanding abortion facility in your community, with far inferior quality of care, the number of such infections will be at least double that of such a medical center.

"One sequel to abortion can be a killer. This is pelvic abscess, almost always from a perforation of the uterus and sometimes also of the bowel," said two professors from UCLA, in reporting on four such cases.
C. Gassner & C. Ballard, Amer. Jour. OB/GYN, vol. 48, p. 716 (as reported in Emerg. Med. After Abortion-Abscess, vol. 19, no. 4, Apr. 1977

In an underdeveloped country, complications are more frequent and treatment is usually less available and effective.

Can infection cause damage?

Infection in the womb and tubes often does permanent damage. The Fallopian tube is a fragile organ, a very tiny bore tube. If infection injures it, it often seals shut. The typical infection involving these organs is pelvic inflammatory disease (PID).

Patients with Chlamydia Trachomatous infection of the cervix (13% in this series) who get induced abortion "run a 23% risk of developing PID."
E. Quigstad et al., British Jour. of Venereal Disease, June 1982, p. 182

"Pelvic Inflammatory Disease (PID) is difficult to manage and often leads to infertility, even with prompt treatment . . . Approximately 10% of women will develop tubal adhesions leading to infertility after one episode of PID, 30% after two episodes, and more than 60% after three episodes."
M. Spence, "PID: Detection & Treatment," Sexually Transmitted Disease Bulletin, John Hopkins Univ., vol. 3, no. 1, Feb. 1983

"Acute inflammatory conditions occur in 5% of the cases, whereas permanent complications such as chronic inflammatory conditions of the female organs, sterility, and ectopic [tubal] pregnancies are registered in 20-30% of all women. . . these are definitely higher in primigravidas [aborted for first pregnancy]."
A. Kodasek, "Artificial Termination of Pregnancy in Czechoslovakia," Internat'l Jour. GYN/OB, vol. 9, no. 3, 1971

Venereal disease, usually Gonorrhea or Chlamydia, causes PID. This, if present, vastly complicates an induced abortion.

"Chlamydia trachomatous was cultured from the cervix in 70 of 557 women admitted for therapeutic abortion. Among the 70, 22 developed acute PID postoperatively (4% of the total)."
E. Quigstad et al., "PID Associated with C. Trachomatous Infection, A Prospective Study," British Jour. of Venereal Disease, vol. 59, no. 3, 1982, pp. 189-192

Another study revealed a 17% incidence of post-abortal Chlamydia infection.
Barbacci et al., "Post Abortal Endometritis and Chlamydia," OB & GYN, 68:686, 1986.

In a classic English study at a university hospital which reported on four years' experience, "there was a 27% complication rate from infection."
J.A. Stallworthy et al., "Legal Abortion: A Critical Assessment of its Risks," The Lancet, Dec. 4, 1971

What of bleeding?

Bleeding is common. Most get by, but some need blood transfusions. The Stallworthy study (above) reported that 9.5% needed transfusions. Most recent studies are reporting smaller percentages.

Are blood transfusions a cause of death in abortions?

Yes, and these deaths are never associated directly nor reported as statistics related to abortions. Here is how this works:

First, we must know how many women need blood transfusions after getting induced abortions. These figures are hard to come by. The only controlled studies are from university medical centers, which do only a small fraction of all abortions. Over 90% of abortions in the U.S. and varying percentages in other nations are done in free-standing abortion chambers where the medical care is only a faint shadow of the competence of those medical centers. Women who hemorrhage from these abortions are sent to "real" hospitals for transfusions and surgery. The percentage who need transfusions then must remain an estimate as these commerical establishments do not report this.

How many then? Let's be conservative and say that one in every hundred needs a blood transfusion. If there are 1,600,000 abortions annually in the United States, this means that 1% or 16,000 women were transfused.

Viral hepatitis is transmitted in up to 10% of patients transfused. Ten percent of 16,000 is 1,600 women.
Amer. Assn. Blood Banks and Amer. Red Cross, Circular Information, 1984, p. 6

An analysis of 300,000 cases of Hepatitis virus infection showed that deaths occurred from three causes: 322 from acute disease, 5100 from cirrhosis, and 1200 from liver cancer. This mortality rate is over 2%.
R. Voelker, Hepatitis B: Planned Standard, Am. Med. News, Oct. 13, '89, pg 2.

Two percent of 1600 women means that ultimately 32 deaths result annually from abortions for this reason.

AIDS is another threat. Two percent of AIDS has been acquired by blood transfusions. With recent careful screening techniques, this is now much less. Even so, 200-400 people in developed countries, per year, are still being exposed via blood transfusions.
Noyes, "Transfusions Risk Despite Screening," Family Practice News, May 15, 1987.

In underdeveloped nations the AIDs threat ranges from seldom to common.

Are blood clots ever a problem?

Blood clots are one of the causes of death to mothers who deliver babies normally. They are also a cause of death in healthy young women who have abortions performed.

Embolism (floating objects in the blood that go to the lungs) is another problem. Childbirth is a normal process, and the body is well prepared for the birth of the child and the separation and expulsion of the placenta. Surgical abortion is an abnormal process, and slices the unripe placenta from the wall of the uterus into which its roots have grown. This sometimes causes the fluid around the baby, or other pieces of tissue or blood clots, to be forced into the mother's circulation. These then travel to her lungs, causing damage and occasional death. This is also a major cause of maternal deaths from the salt poisoning method of abortion.

For instance, pulmonary thromboembolism (blood clots to the lungs) was the cause of eight mothers dying from abortions, as reported to the U.S. Center for Disease Control.
W. Cates et al., Amer. Jour. OB/GYN, vol. 132, p. 169

And this can occur in those as young as 14 years old.
Pediatrics, vol. 68, no. 4, Oct. 1971

Also, amniotic fluid embolism has "emerged as an important cause of death from legally induced abortion." Of 15 cases, the risk seems to be greater after three months. Treatment is ineffective."
R. Guidotti et al., Amer. Jour. OB/GYN, vol. 41, 1981, p. 257

And has an 80% mortality rate.
S. Clark, Amniotic Fluid Embolism, the Female Patient, vol. 14, Aug. '89, p. 50

There are other blood-related problems?

The most feared is Disseminated Intravascular Coagulation. This is a sudden drop in blood clotting ability which causes extensive internal bleeding and sometimes death. The classic paper was on hypertonic saline (salt poisoning) abortions (see reference below).
H. Glueck et al., "Hypertonic Saline Abortion, Correlation with D.I.C.," JAMA, vol. 225, no. 1, July 2, 1973, pp. 28-29

"Saline-induced abortion is now the first or second most common cause of obstetric hypofibrinogenemia." [Same as D.I.C. above].
L. Talbert, Univ. of NC, "DIC More Common Threat with Use of Saline Abortion," Family Practice News, vol. 5, no. 19, Oct. 1975

Since then, it has also been caused by D&E and Prostaglandin abortions.
White et al., "D.I.C. Following Three Mid-Trimester Abortions," Anaesthesiology, vol. 58, 1983, pp. 99-100

What causes perforation of the uterus?

It can be caused by suction, D&C, or D&E abortions. Salt poisoning and Prostaglandin-type abortions also cause perforations, but it is then more accurately described as a rupture or blow-out of the uterus.

How often does perforation occur?

For early abortions, it is plus or minus 1%. In the later ones, it is more frequent.

I've heard that Prostaglandin abortions are safer than the Salt Poisoning type.

This is certainly true for the baby, as more are born alive with this method (see chapter 13).

It is probably also true for the mother. Nevertheless, complications include uterine rupture, cervical laceration, sepsis, mild to severe Disseminated Intravascular Coagulation, hemorrhage, sudden death, convulsions, cardio-respiratory arrest, vomiting and aspiration, stroke, acute kidney failure, amniotic fluid embolus, and blood clots to the lung.

A major study from the University of Texas, Dallas, concluded:

". . . a large complication rate (42.6%) is associated with its [Prostaglandin] use. Few risks in obstetrics are more certain than that which occurs to the gravida [pregnant woman] undergoing abortion after the 14th week of pregnancy."
Duenhoelter & Grant, "Complications Following Prostaglandin F-2A Induced Midtrimester Abortion," Amer. Jour. OB/GYN, vol. 46, no. 3, Sept. 1975, pp. 247-250

Why don't we hear more about such complications?

A busy chief of an OB department in Ft. Lauderdale reported, "An unusually large number of complications are being seen by private physicians. Because many of these adolescent patients, in whom complications develop, do not return to the physician who did the abortion, accurate data on complications are difficult to obtain."

He then discussed 54 teenage patients seen in his private practice (he does not do abortions) in a six-year period. He also noted that, of the young women, "none felt they had been given any meaningful information as to the potential dangers of abortion."
M. Bulfin, "A New Problem in Adolescent Gynecology," Southern Med. Jour., vol. 72, no. 8, Aug. 1979

"There has been almost a conspiracy of silence in declaring its risks. Unfortunately, because of emotional reactions to legal abortion, well-documented evidence from countries with a vast experience of it receives little attention in either the medical or lay press. This is medically indefensible when patients suffer as a result.

"It is significant that some of the more serious complications occurred with the most senior and experienced operators.

"[These complications] are seldom mentioned by those who claim that abortion is safe . . ."
J.A. Stallworthy et al., "Legal Abortion: A Critical Assessment of its Risks," The Lancet, Dec. 4, 1971

Do the statisticians admit their figures are inaccurate?

They seldom do, and that is incredible. Ask a health officer what the Gonorrhea incidence is in his or her county and you will be given the number officially reported. But ask again, "How many cases are there actually?" The answer will likely be, "Oh, we know that only a small percent are actually reported. If you want the true incidence, multiply by three or five or more."

Since the reason to cover up an abortion is far more compelling than the reason to cover up a case of sexually transmitted disease, it should be obvious, as indicated above, that most abortion deaths and injuries are not reported, or are reported as something else.

Reported cases of Gonorrhea increased from 600,000 to 1 million in a five-year period, and "it is estimated that only one-third are reported."
S. Gabbe, OB-GYN News, Oct. 1, 1983, p. 15

I thought that reporting an abortion was required by law.

In many states and nations, reporting is not required. For example, almost five years after legalization of abortion nationwide, the Department of Health of the State of Ohio stated, "The reporting on this statistic has been very minimal. At the present time, there is no information available as to complications of the abortion procedure."
K. Bajo, Asst. Adm., Ohio Dept. of Health Report to Ohio Right to Life, May 3, 1977

But there are studies from universities that report much better safety records.

Some reports are correct. Some of the questionable reports, however, are written by well-known abortionists who are profiting from this grisly business. There are no well-funded, comparably-sized studies done by pro-life physicians.

Also, the standard of care at a university teaching hospital is far better than that at your local abortion mill. The so-called "freestanding clinics," which do over 90% of all abortions in the U.S., are often little better than back-alley operations that have been legalized, and their follow-up care (and ability to report accurately) is usually nonexistent.

The claim that relevant statistics can be collected from the place where the abortion was performed "is little short of science fiction."

"Complications following abortions performed in free-standing clinics is one of the most frequent gynecologic emergencies. . . encountered. Even life-endangering complications rarely come to the attention of the physician who performed the abortion unless the incident entails litigation. The statistics presented by Cates represent substantial under-reporting and disregard women's reluctance to return to a clinic, where, in their mind, they received inadequate treatment."
L. Iffy, "Second Trimester Abortions," JAMA, vol. 249, no. 5, Feb. 4, 1983, p. 588.

But, at least deaths are reported accurately?

All deaths, of course, are reported, but not all abortion deaths are reported as abortion related. If nondisclosure (and, therefore, nonreporting) of venereal disease is the rule, not the exception, how much more pressure is there on the doctor to not disclose that this complication and/or death was related to an induced abortion? Your authors' Handbook on Abortion detailed many specific instances of such cover-up during the 1970s.
Willke & Willke, "Mothers Die from Abortions." In Handbook on Abortion, Cincinnati: Hayes Pub. Co., 1971, 1975, 1979 Editions

* Consider the mother who hemorrhaged, was transfused, got hepatitis, and died months later. Official cause of death, Hepatitis. Actual cause, abortion.

* A perforated uterus leads to pelvic abscess, sepsis (blood poisoning), and death. The official report of the cause of death may list pelvic abscess and septicemia. Abortion will not be listed.

* Abortion causes tubal pathology. She has an ectopic pregnancy years later and dies. The cause listed will be ectopic pregnancy. The actual cause, abortion.

* Deep depression and guilt following an abortion leads to suicide. The cause listed, suicide! Actual cause, abortion.

* If the abortionist does the follow-up care and the patient dies from the abortion, the abortionist doesn't want the reputation of being a butcher, so another cause is listed.

* Usually, however, a different doctor sees a patient who dies from the damage done from an abortion, but she and her family hotly deny the abortion. The abortion connection cannot be absolutely proven, and the new doctor fears a suit for malpractice or for defamation of character, and so he lists another cause.

* The kindhearted surgeon, unable to save the life of an abortion victim, feels that she and her family have been punished enough. He doesn't want to ruin her and her family's reputation in the community -- so he forgets to mention abortion on the death certificate.

How about specific cases? Recently?

One abortion chamber, Woman's Care Center, Biscayne Blvd., Miami, FL, "killed" four mothers: R. Montero (August 7, 1979), M. Morales (May 8, 1981), M. Baptise (December 18, 1982), and S. Payne (January 4, 1983).

The pro-abortion Chicago Sun Times ran a multi-issue expose' in 1978. They discovered 12 mothers who had died from abortions, who had previously been unreported. They also reported abortions being done on non-pregnant women as well as some by incompetent medical persons in unsterile conditions.

"What the Supreme Court legalized in some clinics in Chicago is the highly profitable and very dangerous back-room abortion."
Special Reprint, Chicago Sun Times, Field Enterprises, 1978

That sounds like only a fraction of maternal abortion deaths are actually reported as such!

Most active pro-life people are convinced of this.

But I read that abortion is safer than childbirth!

The most professional analysis of this was by Professor T. Hilgers. He shows that it depends upon the statistics that you use.
T. Hilgers, "Abortion Related Maternal Mortality." New Perspectives on Human Abortion, Univ. Pub. of Amer., 1981, pp. 69-92

But which is safer?

Safety probably isn't a factor. Women don't have babies or choose abortion because of safety. Maternal mortality in childbirth is only 10 deaths per 100,000 deliveries.

Another interesting consideration is that pro-abortion people always compare reported figures of all maternal deaths (10 per 100,000) to mortality figures for only first trimester abortions (1-2 per 100,000), conveniently omitting the deaths from second and third trimester abortions (40-50 per 100,000). If the pro-lifers were to play the same statistical game, they should speak only of deaths from vaginal deliveries (1.1 per 100,000) and omit those from C-section deliveries (100 per 100,000).
Lanska et al., "Mortality from Abortion & Childbirth," JAMA, vol. 250, no. 3, July 15, 1983, pp. 361-362.

Even so, the situation today is better than the "8,000 to 10,000 women who died annually in the U.S.A. from back-alley abortions," isn't it?


Reported Maternal Deaths from Abortion in U.S.

Year Deaths from legal and illegal abortions
1940 1,679
1950 316
1960 289
1966 First State legalized abortion in 1967 120
1970 128
1972 Supreme Court decision in 1973 39
1977 21
1981 8

NOTE: Most abortion deaths are not reported because when they receive emergency care they are listed as a "problem pregnancy" and listed under "childbirth deaths" This not only fudges the abortion death statistics but also gives an unreal number for pregnancy deaths. Wilke had noticed that abortion deaths were under reported but later research showed what was happening and why this was. When Wilke wrote his book, it was generally thought, even in the medical field, that abortion was safer than childbirth because of these grossly fudged statistics. END NOTE

Taken from U.S. Senate graph Chapter 21.

Commenting on the fact that the decline of maternal abortion deaths was greater for the years 1961-68 than after legalization of abortion in the years 1968-73, Dr. Dennis Cavanaugh stated that, since abortion has been legalized,

". . . there has been no major impact on the number of women dying from abortion in the U.S. . . . After all, it really makes no difference whether a woman dies from legal or illegal abortion, she is dead nonetheless. I find no comfort in the fact that legal abortion is now the leading cause of abortion-related maternal deaths in the U.S."
D. Cavanaugh, "Effect of Liberalized Abortion on Maternal Mortality Rates," Amer. Jour. OB/GYN, Feb. 1, 1978, p. 375

What, then, is the bottom line?

Most women have abortions without significant physical injury, but a disturbing number do sustain damage, and some die.

NB: Recent research has shown that 25 percent of surgically aborted women suffer some type of serious complication including bleeding out, sterility etc. This is a higher percentage than formerly thought when Dr Wilke wrote this book. And of course according to 38 worldwide studies, there is a greatly increased risk of breast cancer among aborted women. This was also unknown at the time that Dr Wilke wrote this book.

Thus the bottom line in the 21st century is that a SIGNIFICANT number of women suffer lifelong physical damage from abortion including a greatly increased risk of breast cancer as much as 250 percent in women who aborted under the age of 18 (according to the Janet Daling study for one and others also) and 85 percent of women suffer lifelong psychological damage from abortion including increased suicides, addiction, post traumatic stress etc.

Abortion, it seems is as unhealthy for the woman as it is for the baby...

Many women end up with real emotional and guilt after-effects.